Cost variation in child and adolescent psychiatric inpatient treatment
Cost variation in child and adolescent psychiatric inpatient treatment
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DOI：
10.1007/s00787-009-0008-9
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发表时间：
2009-09-01
影响因子：
6.4
通讯作者：
Dunn, Graham
中科院分区：
文献类型：
--
作者：
Beecham, Jennifer K.;Green, Jonathan;Dunn, Graham
可公开获得的儿童和青少年精神科住院服务的成本数据不允许与患者的需求和结果建立联系。如果没有这方面的信息，专员们可能会仅仅根据预算影响来降低住院服务的作用。这项研究估计了住院前、住院期间和住院后的支持成本，并探索了成本、需求和结果之间的关系。对8个儿童和青少年单位进行了详细的前瞻性队列研究，参与者在转诊、入院、决定出院和一年后进行评估。平均入场费为24,120澳元，尽管幅度很大。研究发现，费用与患者的整体损害、年龄和排斥状态之间存在关联。入院后的支持费用与入院前的费用相似，但有一些证据表明，服务更有针对性。英格兰为住院精神病发作制定国家关税的举措应该基于治疗发作的可能成本，而不是每天的成本，而良好的调试需要更多关于此类成本预测因素的信息。
Publicly available costs data for child and adolescent psychiatric inpatient services do not allow links to be made with patients' needs and outcomes. Without this information commissioners may reduce the role of inpatient services on the basis of budgetary impacts alone. This study estimates the support costs before, during and after an inpatient admission and explores the associations between costs, needs and outcomes. A detailed prospective cohort study of eight child and adolescent units was undertaken in which participants were assessed at referral, admission, decision to discharge and 1 year later. Mean admission costs were A 24,120 pound, although the range was wide. Associations were found between costs and patients' global impairment, age and exclusion status. Support costs after admission were similar to pre-admission costs, but there was some evidence to suggest that services were better targeted. Moves in England to develop national tariffs for inpatient psychiatric episodes should be based on the likely cost of the episode of treatment rather than costs per day, and good commissioning requires more information on the predictors of such costs.